Meet The Gay Man and the Virginia Organization Turning House Parties into mpox Vaccination Sites

"It was incredibly terrifying. We had no idea what was happening to our bodies—to our collective body."

That is how Clay Porter, MPH, an outreach coordinator at MASS (Minority AIDS Support Services, Inc.) in Newport News, VA recalls reacting to the emergence of mpox as an imminent threat to gay and bisexual men at the start of the outbreak. An epidemiologist focusing on HIV/STI intervention among LGBTQ and people of color, Porter says he returned to an outdated outreach model when the facts about the transmission of mpox were still evolving.

"I reintegrated abstinence as an outreach model, and that's something I haven't used in 20 years," Porter says. "We go back to absence because we have no idea what this is and why it's causing excruciating pain and deep isolation."

Prioritizing those most vulnerable to infectious disease acquisitions is integral to MASS and Porter's mission work. His efforts to keep sex workers safe during the outbreak, in conjunction with his decision to challenge the vaccination efforts by the Virginia Department of Health, illuminates the benefits of a holistic approach to care through a lens that encompasses the impact of race, stigma, and economic disadvantages of the most marginalized.

"I started challenging the health department because their outreach program was immediately LGBTQ," Porter says. "Yes, the data suggested men who have sex with men were predominantly getting this virus. However, in our area, the leading LGBTQ organization [centers the majority]. While they do target Black MSM (men who have sex with men), it is not overwhelmingly so." 

Porter adds, "if you're leaving out the entire bottom, which is an intersection of everyone, every identity, women, sex workers, people who use drugs, people who are of color, Black and Latino, to prioritize LGBTQ, which tends to be white—that is not how you stop the pandemic." 

Porter tells GLAAD that although public health officials in Virginia had good intentions for organizing vaccination events at LGBTQ venues, they failed to understand the stigma people of color would have to navigate before showing up to be vaccinated.

"Having these initial events sponsored by the Health Department at LGBTQ clubs in Norfolk only, run by an LGBTQ organization at an LGBTQ venue, is incredibly exclusive and left our most vulnerable populations entirely out of the vaccination," he says. "But also, people aren't showing up to that event because it's outing them."

And because MASS understands the intersection of race, sexuality, and the impact of homo/transphobia in healthcare settings, Porter says the organization began promoting its vaccination events in an area historically neglected.

"We organized a clinic in the Norfolk area on Tidewater, specifically Huntington, the area's oldest and most historic Black neighborhood in Norfolk. It's impoverished, again, by design," Porter says. "That's the population who's not going to go to a clinic at The Wave, which is a gay club."

But Black gay, bisexual, and men who have sex with men will show up to a house party. With the help of a generous $25,000 grant recently awarded by the Centers for Disease Control and Prevention (CDC) to increase mpox vaccine equity, MASS is utilizing an outreach method that places its organization at the party's center.

Modeling true equity

According to Porter, the decision to apply for the CDC grant occurred when it became clear that Virginia would not approach mpox vaccine distribution equitably.

"We saw the absence of direct action toward Black people, trans people, and the populations in between—the unhoused and speakers of other languages," Porter says. "There was absolutely no targeted approach." 

Porter says MASS is leveraging outreach staff on social media to recruit community leaders representing each of the most vulnerable populations for mpox.

"We're incentivizing individuals to not only come to the [house party] event and receive vaccination as a point of care, but we're also activating that individual to be a change agent in their community," he says. "The clinical approach is to provide care and move on. That's not what we do. We [provide] a holistic approach."

Using the house party method, MASS incorporates HIV/STI education and mpox vaccinations in a comfortable cultural environment for Black gay, bisexual, and MSM through an equitable approach that Porter believes will drive results.

"The status-neutral service navigation approach allows us to reduce all the barriers and achieve equity," he says. "If perhaps the person is hungry, no one is thinking about a vaccine if they're starving."

Porter says the status-neutral service navigation approach includes housing referrals, food referrals, job training, clothing, GED access, and transportation, among other services. In addition, MASS hopes to become the first organization on the east coast, following San Francisco AIDS Foundation, to offer Doxy PEP, a single dose of doxycycline 200 mg proven to reduce the incidence of STIs when taken within 72 hours after sex.

"It's going to be a game-changer," Porter says.

Before MASS received the CDC vaccine equity grant, Porter reiterated the organization had already implemented the method through its operating budget, which the CDC's financial support has now bolstered.

"We did it because it was the right thing to do. Not because we had some government mandate to do it. It was because it was correct," Porter says. "One of the things that makes MASS unique is that we are always going to prioritize the most vulnerable. When we say equity, we mean equity."